Hartford Business Journal

20 HARTFORDBUSINESS.COM | JUNE 1, 2026 Cost Control Weight-loss drug coverage tests employers' health plan budgets spending, the CT Mirror previously reported. In the state employee health plan, Comptroller Sean Scanlon said spending on GLP-1 weight- loss drugs had been rising about 50% annually before Connecticut implemented its FlyteHealth weight management program. Employers, though, may still choose to cover the drugs in the hope they "will really turn the tide on the obesity epidemic in general and positively impact those downstream medical costs that have increased as well," Silvis said. So far, however, employers generally have not viewed GLP-1 coverage as a meaningful recruiting or retention tool, she added. Insurers step in Major insurers also have developed programs aimed at helping employers control GLP-1 costs. Bloomfield-based The Cigna Group offers three such programs through its pharmacy-benefit subsidiary Ever- north, including EncircleRx, which pairs GLP-1 coverage with lifestyle support and cost controls. The program has more than 12 million enrollees, according to Cigna. During the insurer's April 30 earnings call, President and Chief Operating Officer Brian Evanko, who is set to become CEO on July 1, said the percentage of clients covering weight management medications has remained relatively stable from 2025 to 2026. What has changed, he said, is that more employers are looking for programs that pair drug coverage with clinical oversight and lifestyle support. CVS Health, parent company of Hartford-based health insurer Aetna, said high prices set by GLP-1 drug manufacturers remain the biggest obstacle to broader access. "Many payers, including state Medicaid plans and state employee benefit plans, have declined to cover GLP-1s for weight loss because of the unsustainably high prices," the company said in a statement to the Hartford Business Journal. CVS said its pharmacy benefits manager, Caremark, seeks to expand access to weight-loss drugs by "using competition to drive lower costs." Bloomberg News reported in May 2025 that Caremark secured a steep discount from pharmaceutical company Novo Nordisk to make Wegovy a preferred option over competing GLP-1 medications, a move projected to save some health plans up to 15% on annual anti-obesity drug costs. Mercer's Silvis said employers are trending toward developing GLP-1 strategies that seek to help employees improve their overall health. That could mean an employee is required to try a gym membership or nutrition counseling before starting or continuing a GLP-1 medication. "It'll balance access to the drug with guardrails," she said. By David Krechevsky davidk@hartfordbusiness.com A s demand for weight-loss drugs such as Ozempic and Wegovy grows, employers are grappling with a difficult question: whether the potential long-term employee health benefits justify the near-term cost of covering the medications. For many businesses, the answer is complicated, especially as healthcare spending continues to climb. The average cost of employer-spon- sored health insurance reached nearly $17,500 per employee last year, according to a national survey released in November by business consultant Mercer. That marked a 6% increase, outpacing both inflation and wage growth. A major contributor was prescrip- tion drug spending, which rose 9.4% in 2025, driven in part by growing use of GLP-1 medications, some of which have list prices exceeding $1,000 per month, according to various estimates. That has employers paying close attention: 77% of companies said managing GLP-1 costs is either an "extremely important" or "very important" priority this year, according to the Mercer survey. Connecticut has already taken steps to address similar cost pressures in its state employee health plan. As part of a cost-control effort, the state in 2024 agreed to a three-year extension of a pilot program requiring members seeking GLP-1 prescriptions for weight loss to enroll in a weight management program run by New Canaan-based healthcare services company FlyteHealth. A new analysis commissioned by the comptroller's office found the program helped slow growth in participants' medical costs, even as prescription drug spending continued to rise. Private employers are increasingly pursuing similar strategies. A separate survey released in May by the Business Group on Health, a Washington, D.C.-based nonprofit focused on employer healthcare policy, found that 67% of employers cover GLP-1 drugs for weight manage- ment, though many impose conditions aimed at limiting their use or ensuring clinical oversight. "Almost every plan will cover GLP-1s when it's used for diabetes, and that's been the case for several years now," said JoEllen Silvis, a principal with Mercer's health and benefits practice in Connecticut. "But when we're looking at weight loss, that's definitely a different story." Weighing the costs In Connecticut, 55% of large employers — those with between 500 and 20,000 employees — cover GLP-1 medications for weight loss, according to Mercer data cited by Silvis. Most of that coverage comes with conditions. Mercer found nearly half of Connecticut companies require prior authorization, meaning employees must get insurer approval and meet eligibility requirements — such as a minimum body mass index or related conditions like sleep apnea — to be eligible for coverage. Only a small percentage of Connecticut companies cover the drugs without prior authorization, and no particular industry appears significantly more or less likely to offer coverage, Silvis said. Meantime, cost concerns may grow further as new forms of the medi- cations enter the market. Prices for injectable GLP-1 drugs have declined somewhat, Silvis said, but newer pill versions are gaining traction and carry higher costs. The Business Group on Health survey found that 87% of employers expect GLP-1 pills to increase overall demand, while only 9% expect lower prices. "In general, just covering weight-management drugs could increase total health costs by up to 10% over time," Silvis said. Connecticut has already seen the financial impact. GLP-1 medications cost the state's Medicaid program $85 million in fiscal 2024, accounting for 35% of its net pharmaceutical Percentage of U.S. employers that cover GLP-1 drugs for obesity treatment Year Percentage 2023 41% 2024 44% 2025 49% Note: This data is for companies with 500 or more employees. Source: Mercer National Survey of Employer-Sponsored Health Plans JoEllen Silvis Image created by ChatGPT FOCUS | EMPLOYEE HEALTH & WELLNESS

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